常规RhE抗原检测对提高临床精准输血水平意义的研究

Study on significance of routine RhE antigen detection for improving clinical precision blood transfusion

目的:了解人群Rh E抗原分布及受血者抗-E抗体检出率,探讨临床常规检测RhE抗原的必要性。方法:①采用盐水法和凝胶卡法对某医院2015-09—2016-01献血者、2015-01—2015-12受血者进行ABO及Rh(E)血型鉴定;②采用凝胶卡法对2015-01—12受血者进行抗体筛查,并对抗-E阳性者测定抗-E效价;③查阅输血资料,统计RhE(-)受血者输注RhE(+)血的情况,并鉴定输血后的Rh(E)血型。结果:①2591例献血者和33826例受血者,Rh(E)阳性率分别为43.69%(1132/2591)和42.64%(14424/33826);②33826例受血者,抗体筛查阳性264例(0.78%),其中抗-E为108例占抗体筛查阳性结果的40.91%;抗-E效价主要分布在4~16之间;③接受RhE(+)血的受血者中,RhE(+)468例(48.75%),RhE(-)492例(51.25%)。106例RhE(-)受血者输入RhE(+)血后,50例(47.17%)RhE血型鉴定结果变为双群。结论:为实现RhE同型输血,降低输血抗-E产生率,减少输血不良反应,提高临床精准输血水平,临床输血检验中除常规鉴定ABO血型和Rh(D)血型,常规鉴定Rh(E)亦同等重要。

Objective:To investigate the distribution of Rh E antigen in human population and the detection rate of anti-E antibody in recipients,and explore the necessity of routine detection of RhE antigen.Method:①ABO and Rh(E)blood group identification was performed on blood donors from September 2015 to January 2016 in a hospital and blood recipients from January 2015 to December 2015 using saline method and gel card method.②The gel card method was used to screen the recipients from January to December 2015,and the anti-E titers were determined against the anti-E positives.③The blood transfusion data were reviewed and the RhE(+)blood loss was counted.In the case of the recipient,and the recipient of the blood receiving the blood of the RhE(+)donor,the Rh(E)blood type after transfusion was identified.Result:①The positive rate of Rh(E)of 2591 blood donors and 33826 recipients was 43.69%(1132/2591)and 42.64%(14424/33826),respectively;②The positive rate of antibody screening in 33826 recipients was 264 cases(0.78%),of which 108 cases of anti-E accounted for 40.91%.The anti-E titers were mainly distributed between 4 and 16;③Among the recipients receiving RhE(+)blood,468 cases of RhE(+)accounted for 48.75%,and 492 cases of RhE(-)accounted for 51.25%.After 106 RhE(-)recipients received RhE(+)blood,blood group identification results of 50 cases(47.17%)became double groups.Conclusion:To achieve RhE homologous blood transfusion,reduce anti-E production rate,reduce adverse events of transfusion,and improve clinical precision blood transfusion level,In addition to routine identification of ABO blood type and Rh(D)blood type in clinical transfusion test,routine identification of Rh(E)is equally important.